Executive summary

This booklet provides a summary of the four subsequent booklets of the World Drug Report 2019 by reviewing their key findings and highlighting policy implications based on their conclusions. The main findings in 2019 were:

  • In 2017, an estimated 271 million people, or 5.5 per cent of the global population aged 15–64, had used drugs in the previous year, while 35 million people are estimated to be suffering from drug use disorders.
  • Around 53 million people worldwide had used opioids in the previous year, these estimates are 56 percent higher than previously estimated. Among those people around 29 million had used opiates such as heroin and opium – these estimates are also 50 percent higher than previously estimated.
  • The higher estimates in 2017 are the result of improved knowledge of the extent of drug use from new surveys conducted in two highly populated countries, namely India and Nigeria.
  • Opioids continue to cause the most harm, accounting for two-thirds of the deaths attributed to drug use disorders.  People who inject drugs — some 11 million worldwide in 2017 — endure the greatest health risks. More than half of them live with hepatitis C, and approximately one in eight live with HIV.
  • The Global Burden of Disease Study 2017 estimated that, globally, in 2017, there were 585,000 deaths and 42 million years of “healthy” life lost as a result of the use of drugs. Around half of the drug related deaths were attributed to untreated hepatitis C.
  • For people with drug use disorders, the availability of and access to treatment services remains limited at the global level, as only one in seven people with drug use disorders receive treatment each year.
  • Drugs such as heroin and cocaine, that have long been available, increasingly coexist with NPS, while there has been an increase in the non-medical use of prescription drugs (either diverted from licit channels or illicitly manufactured). Many pharmaceutical and prescription drugs figure prominently in the poly drug use patterns of users of opioids and stimulants such as cocaine and amphetamines.
  • In recent years, hundreds of NPS have been synthesized. Synthetic opioids,  mostly fentanyl analogues  have become the second most important substance group, after stimulants, in terms of NPS reported for the first time.
  • Overall, the global area under opium poppy cultivation is the second largest ever estimated, after the record high of 2017, largely as a result of a drought in Afghanistan.
  • Coca bush cultivation and manufacture of cocaine have reached record highs in 2017. In North America, Western and Central Europe, Oceania and some South American countries there are now signs of an increase in cocaine use. In parts of Asia and West Africa, increasing amounts of cocaine have been reported to be seized, which suggests that cocaine use could potentially increase, especially among affluent, urban dwellers in subregions where use had previously been low.
  • The non-medical use of prescription drugs is becoming a major threat, especially with different pharmaceutical opioids being misused in different regions. Tramadol, an opioid painkiller, is widely trafficked for non-medical use in Africa. It is becoming a major threat in West and Central Africa and in North Africa, from where some of it is trafficked onwards to countries in the Near and Middle East. In North America, the non-medical use of pharmaceutical opioids continues to be an epidemic with historic increases in the number of overdose deaths mainly attributed to the use of synthetic opioids (mainly illicitly manufactured fentanyls).
  • Methamphetamine use is causing rising concerns across several regions. Quantities of methamphetamine seized in East and South-East Asia rose more than eightfold between 2007 and 2017 to 82 tons – 45 per cent of global seizures. Preliminary data for 2018 suggest a further steep increase to roughly 116 tons. Most countries in South-East Asia report methamphetamine as the main drug of concern in treatment. Also, while the non-medical use of pharmaceutical stimulants is more prevalent in North America, a significant number of people also use methamphetamine.